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Care Delivery


Anthem has been criticized and even sued over policies in several states where it won’t pay for emergency room visits it later determines to be unnecessary. The insurer has now softened those restrictions, but American College of Emergency Physicians (ACEP) said the changes don’t go far enough.

Purdue Pharma, best known for making and selling OxyContin, announced Feb. 10 that it will stop marketing opioid drugs to physicians. The company also stated it will lay off half of its sales force, with the remaining staff of 200 focusing on other medications.

Medicaid patients face a host of challenges in accessing care, with reliable, timely transportation often being a major consideration. A recently published study, though, showed rates of missed primary care appointments were unaffected when Medicaid patients were offered free ridesharing services.

Some 11.8 million people signed up for coverage through the Affordable Care Act (ACA)’s insurance exchanges for 2018, down from 12.2 million the year before. Considering changes that were expected to depress enrollment—like HHS shortening the open enrollment period for and cutting its advertising budget by 90 percent—signups “remained generally stable,” according to a report from the National Academy for State Health Policy (NASHP).

In 2011, as outlined in the Affordable Care Act (ACA), Medicare began offering wellness visits at no cost to fee-for-service beneficiaries. The goal of the annual checkup was to introduce preventative care and address specific risks such as depression and risk of falling.


Recent Headlines

Royal Philips, Calif. hospital announce 15-year, $90 million partnership

Royal Philips and Greenbrae, Calif.-based Marin General Hospital (MGH) announced this week they have agreed to a 15-year, $90 million strategic partnership to improve the overall quality of care the hospital can provide.

Study: 1 in 3 working-age cancer survivors go into debt

Approximately one in three working-age cancer survivors went into debt after beating the disease, according to a recent study published in Health Affairs. In addition, three percent of those individuals filed for bankruptcy as a result of their high medical bills. 

CMS announces initiative to address health-related social needs

The Centers for Medicare and Medicaid Services (CMS) recently announced a initiative that may help some health systems address patients’ health-related social needs.

Demand on the rise for EMR-dedicated scribes

The Affordable Care Act is swelling patient rolls while CMS continues slapping EMR-resistant providers with increasingly hefty financial penalties. What’s an already overburdened doctor to do? 

What will 2016 bring to healthcare? Business watchers, presidential candidates give hints

2016 will be the year U.S. healthcare seriously reckons with consolidation, much of it brought on by Obamacare, as mergers and acquisitions continue among providers, payers and industry players—and as regulators assert their power to stem or encourage the tide.

Study: Nearly one-third of all resident physicians suffer from depression

More than 28 percent of all resident physicians suffer from depression or depressive symptoms, according to a study published this week by JAMA

HHS report: 87,000 lives saved by patient safety efforts

According to a new HHS report, patient safety efforts from 2010 to 2014 saved approximately 87,000 lives and $20 billion in healthcare costs. 

CMS seeks comments on survey regarding inpatient rehabilitation facilities

The Centers for Medicare & Medicaid Services (CMS) published a request for information on Nov. 20 asking healthcare providers for their assistance in designing and developing a survey on patient and family experiences with inpatient rehabilitation facilities.

UnitedHealth warns of significant losses in health insurance exchange products

UnitedHealth Group significantly reduced its earnings projections for 2015 in large part because of a “continuing deterioration” in plans it offers on the health insurance exchanges created by the Patient Protection and Affordable Care Act (ACA).

ACP releases position paper on concierge medicine and direct patient contracting

The American College of Physicians (ACP) released a position paper on Nov. 10 on the increasing popularity of concierge medicine and direct patient contracting practices (DPCPs) and patient care implications of the arrangements. The paper was simultaneously published in the Annals of Internal Medicine.